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Morris Returns from the doctor and tells his wife that the Doctor has told him that he has only 24 hours to live. Given the prognosis, Morris asks his wife for sex. Naturally, she agrees, so they make love. About 6 hours later, the husband goes to his wife and says, 'Honey, you know I now have only 18 hours to live. Could we please do it one more time?' Of course, the wife agrees, and they do it again. Later, as the man gets into bed, he looks at his watch and realizes that he now has only 8 hours left. He touches his wife's shoulder and asks, 'Honey, please... just one more time before I die.' She says, 'Of course, Dear,' and they make love for the third time. After this session, the wife rolls over and falls asleep. Morris, however, worried about his impending death,tosses and turns, until he's down to 4 more hours. He taps his wife, who rouses. 'Honey, I have only 4 more hours.... Do you think we could...' At this point the wife sits up and says, 'Listen Morris, enough is enough I have to get up in the morning... you don't.'

A big hit in the classes I taught to kids was some type of a demonstration. When my daughter was in 2nd grade, I spoke to her class- the usual safety ideas- helmets, traffic safety, simple rules of the road, stop, drop and roll, meeting points, smoke detectors, basic first aid, what to say when calling 911. The biggest hit- using my daughter as a guinea pig. I set up a scenario- going to baseball practice/dance class/the grocery store, etc, and you get into a traffic accident, someone calls 911, and they see what happens. Be creative and dramatic with the scenario- the story was important to the set up- they all love drama and a good story. I showed them what would happen to them once the ambulance arrived. Quick exam, vital signs, etc. I put on a C-collar, splinted her broken arm, and secured her to a backboard, and wrapped up her injuries. I even got the kids involved. They LOVED it. 3 years later I still hear how much the kids loved that day. My daughter earned major brownie points with her friends because she was so brave. LOL You can even tailor the scenario to the older students. On the way home from a date, the driver was DUI. Make the injuries severe enough to scare them. Use the cardiac monitor, pretend you are starting an IV, "check" their glucose levels, etc. I saw a recent You tube video that showed a bus accident and how unrestrained folks fly around. It was VERY dramatic and showed the forces involved in an accident. I found that just lecturing them makes their eyes glaze over- especially the older ones, but object lessons tend to get their attention. Of course, handing out goodies- stickers, pencils, books, fire hats, etc are always a big hit too.

Respectfully, not an apples to apples comparison. 1- Schools (and school districts) are mandated, though the quality is debatable. EMS is mandated too, but not the way schools are. 2- School districts in rural settings receive HEAVY subsidies from both the state and federal government EMS has not since the 1980s when Reagan shut that down. (Still love the man though!!!)There are no subsidies for EMS. This is not a local issue, but a state/Federal one, and cannot be pinned on the locals "not thinking EMS is important". Interestingly enough, most of these agencies subside ONLY on donations, so someone thinks their important. 3- By contrast, EMS is a mandated service for every county to provide , but unfunded by either the state or federal government, a fact we all are of aware of here, nor does the mandate say the county has to provide good EMS. Ironically, many of these rural EMS agencies would get more money if they simply bought an old fire engine, added the words "Fire and Rescue" to the end of their name, and applied for SAFER grants. I AGREE THAT AS A NATION THIS COUNTRY PUTS FAR TO LITTLE EMPHASIS ON EMS IN COMPARISON TO FIREFIGHTING AND LAW ENFORCEMENT...but thats a federal issue. And its not just funding, but minimum standards (when will degrees become mandatory for medics dammit!!!), legislation, and other forms of support too. But thats not the focus of THIS thread. The focus of THIS thread, as I read it, is some feel that the use of ECAs on the ambulance is an EPIC FAIL. Usually (making assumptions here) this is by people with little of no frame of reference to the challenges and start realities of some parts of thsi country. Everywhere is not California, Dallas, New York, or Saint Louis. You dont have a trauma center in every state (Ex. There is no LEVEL I TRAUMA Center in Idaho, ANYWHERE). You dont have taxing districts, or first responders, or even law enforcement when you need it. My point was to provide a frame of reference. RIGHT OR WRONG, these services are serving isolated pockets of humanity with populations less than some of our apartment complexes. There are seem fiscal realities that go with that situation. In these unique situations, staffing an ambulance is a challenge, and using ECA's so you can have an EMT in the back is a victory in some parts of the country. I was curiosu and did some basic research....Looking at the population base of the community mentioned in the OP, the population density, and the median income, this is likely one of those situations. Is it ideal, no. But stomping our foot and demanding that somehow things change wont help it. Demanding that we put more money in the situation and have "Paid" EMTs wont help either when there is no money to put in there. I work with these rural EMTs on many occasions (well nto the rural EMTs mentioned in the article, but here in ID). Sure there are some things that could be improved on. IMHO, the limited $$$ could be stretched way farther with regional cooperatives. But the independent spirit that has kept these communities alive in the face of significant adversity often gets in the way of cooperation. But this is true in many rural communities and even urban ones, not just in Idaho. So my point is that if my service chose to staff ECAs to scrape an extra $$, it would indeed be a fail. But for these communities its not a matter of scraping a dollar, its about getting bodies in the door, and hooked on EMS, so you can get them on to be EMTs later. Other than the use of the term "driver" (which we all universally hate) this is a community EMS trying to recruit and keep their ambulances staffed and on the road. SO, best of luck to them. Again, respectfully Submitted. - Steve

What is with this new trend of telling folks, 'specially our new members, not to ask questions here? That is what the City is for, isn't it? This is making me batshit. Answer the question, don't answer the question, ignore the entire thread if you want, but who are you exactly to be telling folks which questions are allowed here? When did we decide that some questions were just so beneath us that we needed to explain to folks how dumb they are? How about we stop that habit now and replace it, say, with pics of boobs. Anytime you feel the need to tell someone not to post you post a pic of boobs instead? I believe the world, and certainly the City, will be the better for it. OP, you didn't mention when you are using these new found skills. Is it at work? Or from your private vehicle? Are you being paid to provide them, or doing them as a volly? I think all of these things make a difference, but I'm not exactly sure. Also, take a look at the Good Sam laws and see if you fit... Dwayne

Happy 2010 EMS Week!!! Just wondering, what are you doing for EMS Week this year? We have a Gourney Rodeo, gift card drawings, BINGO, Ice Cream Social lunch with fire (not sure how I am gonna eat around a fire ), pancake breakfast, and lunch at several ERs. We may also wear EMS Week T-Shirts rather than our usually uniform. Going to the Rodeo here in just a bit, really not a 100 percent sure what I am getting into but I figured what the heck. Not sure how much of the other stuff I will actually be involved with as I work the graveyard shift but it is nice to have to opportunity. Have fun out there and enjoy the week.

Show them some of your equipment. Explain what things are and what they do. Don't get into details. Think meat and potatos hold the salt and butter type of thing. Should they ever see you on a call everything is scary as hell. What things do you know they will see no matter what? BP cuff, pen light, etc right? So bring that in. Heck let them take your vitals! Ok this sounds stupid I know. But if you show them the "scary monster tools" ( to quote Brett Jr a year ago) now while they know they are safe they will be less scared later. When I did my pen pal project my kids loved it. They got to see the tools, learn what they were for, and a few even still remember. We did a few extreme basic drills. One parent has asthma, one smokes, and one of my kids is accident prone. So guess what we did? How to help mom find her rescue inhaler and call 911, how to get out of a house durning a fire and call 911, and how to take care of boo boos. Take in a run report and show them what you are looking for. Always remember to keep your voice lively. Remember your rule of 3: males raise your voice 3 octives ( yes you want to sound like a hyper cheerleader). Jump, skip, run to places. The more cartoonish you act the more they will pick up at the younger ages. Ok I'll take my preschool teacher hat off now.

You know what I drives me crazy about these conversations is that people have a hard time understanding that we can not like a system, but not dislike ALL of the people in it. I'm not a fan of volly system, and very much not of fire fighters, yet my partner and friend is a basic, medical responder volunteer and chief of his volly fire dept. And I couldn't like or respect anyone more than I do him. He's smart, really smart, dedicated, is working, as he has been for several years, to turn his dept paid, and is willing to admit to all of his personal failings as well as those of the paid and volly systems he works within. Yet, some people are still sometimes shocked when I throw him the drug bag when we go on an arrest and simply acknowledge as he calls out the drugs he's about to push while I spend my time doing other things...(I rarely transport CORs unless we get ROSC.) Should I not allow him those responsibilities because he's a basic and a volly and, God forbid, a hosemonkey? People hate some medics because they're ignorant, lazy, and arrogant. I'm not, so I'm not offended by those comments for the most part. Many vollies are lazy, idiotic, hero seeking idgits...if you're not, then let that pass and continue the discussion of the systems without personal offense. There are many, many really, really good people inside of bad systems, but those people, no matter how good, don't make the SYSTEM good, See?? Take a breath folks, separate individuals from groups, and don't take offense. We're all part good, part idiot, part competent, part asshole...if you're not being singled out as a majority of one or another, then take a pill...OK? Dwayne

WAY to general of a statement. Example, I am proud to say I believe I work in one of the top 10% of EMS agencies in the nation here in Idaho. We serve an indigenous population of about 350K with a transient workforce of about 75-100K from out of county, and are a pleasant mix of suburban, rural, and even a little bit of urban thrown in, with median income from near zero to over 1 mil and everwhere in between. Sounds great, right? HOWEVER, you go north of here into the mountains, where most of the land is federal or state forests, The populated areas are small barely sustained communities of less than 1000 people....and these are the the "LARGE" communities,and are separated by mountainous terrain and snowed out roads in the winter for WEEKS at a time. This is not the natural disasters you see on CNN. This is the NORM. These communities are unincorporated, and have no tax base to speak of, and the EMS lives of the generosity of donations. The Counties they live in are little better. These community first responder/transport units often get less than 20-50 EMS calls a YEAR. Some examples: Valley County Idaho- Population 8000 total over 3678 square miles. An average population of 2 people per square mile. Yet most of this population lives in three communities along HWY 55, and are SEASONAL populations. the REAL population once you get off the HWY into the 6 or 7 uncooperative communities is closer to 0.25-0.5 people per square mile. Custer County Idaho: 4,166 (and decreasing BTW)in 4,937 square Miles. Less than 1 person per square Mile, and most of this population is in CHALLIS (pop 909), McKay (pop 500), STANLEY (pop 100) and other communities with a population of about 25-50. , Population is very seasonal, and mostly around red fish lake. The remainder of this population is spread out among 4-6 "smaller" communities. Many of these communities are vacated (except for 1-5 families as caretakers) during the winter. Adams County, Population 3400 over 1,365 square miles, most are seasonal with a ski resort or between two small communities each with less than 900 and 500 respectively. The remaining are scattered through out the mountains and along the river, many are "off the grid", and real population density is about 1/square mile or less. These are typical Idaho counties in MID/Central Idaho (where the Mountains and Valleys are). Hopefully you can see the budgetary issues, not to mention the personnel shortage this causes. Making a system out of a seasonal workforce and without a decent tax base is neigh impossible. In Texas, I only found one or two counties resembling this demographics on simple square miles (brewster for example) , They were agricultural in nature, not necessarily seasonal as we understand it here, and arent ISOLATED like we are for weeks or months at a time. Most had counties less than HALF this size, and population densities far exceeding what we have here in rural Idaho. THATS the REALITY here. And there are similar areas in OR and WA too, and in other parts of the country (SD, WY, and MT for example) You seem to imply that these comminities simply are to lazy to do anything other than volunteer EMS with an EMT and A "driver"/ECA. You seem to imply that if they wont do it "right", they should not do it at all. Yet without their own volunteer EMS, they would be HOURS in winter from anyone getting in by snowmobile or snow cat, or 4x4. If you have a population of say, 1000 (wich is the upper end of the LARGER communities, amy have populations less than 100). and you have an unheard of rate of 2.5% voluntarism, than thats still only 25 volunteers. In this state fully half of those will go to a first responder course and be a "driver", as long as there is an EMT in back. Then , if they stick with it, the service will find a way to send them to a EMT course, many will have to travel an hour or more to get that course in the summer. Now the state requires an EMT in the back, and at least a driver in the front. Most will run with 2-3 man crews on call from home. Usually the same people will be on call for weeks at a time. In the summer, they ONLY have to manage the patient for 20 minutes until air medical can get there, if they can get there (mountains are tricky to fly in).......In Winter, due to weather, white out, and other concerns, it may be hours to ALS or a facility thats more than a clinic and a PA/NP on call. In these areas, called FRONTIER, or SUPER-RURAL by medicare, ECA/First Responder/Drivers are the brutal reality, and the step to EMT in areas with no budget and no support. I am all for "doing it right", but in the rural parts of this state, every certificate that is issued is a victory, and everyone that re-certs, is a triumph. You have to see these beautiful, scene, and terrifyingly majestic areas to appreciate the isolation you can find here. I have volunteered my time to teach in some of these communites from time to time. It is way more rewarding than doing it in the "Big City" of Boise... (I have to laugh when I say that). And these guys are wanting the training. They just dont have the resources. In some places, "Doing it right" is simply doing it. Respectfully submitted. P.S. There is a push by the state to legislate counties into taking a more active role in supporting and funding these communities EMS and forming SYSTEMS....., and in forming taxing districts to support those "systems"......but guess who opposed it. The various FF lobbies. They dont want to be told how to run EMS by anyone.....)

It's not hard to drive an ambulance, not hard at all. Being an EMT doesn't make you a better driver. Being a medic doesn't make you a better driver. I just think you people need to find something more interesting to bitch about.

They are quite capable individuals in many ways. These people are not hobbyist. They are simply citizens helping their community, a term apparently vacant from the vocabulary of many on this network site. Do your homework before you go bashing on other EMS agencies ways of working. This particular service can not afford to staff that many paid providers, not to mention they have 2 medics, 2 WHOLE MEDICS!!! The rest of their service is comprised mostly of ECAs and EMTs. These are not stupid or lazy people. Just because they have some other full time job does not make them less of an EMT, ECA, or Paramedic for that matter. If anything it broadens their ability to help others for engagin them in the empthetic aspects of the job. By the way, the State of Texas is perfectly aware of systems that work in this fashion. They MADE IT THAT WAY!!!!! Because they have sense enough to realize that not every area will be needy of fully staffed and paid services. Nor could they afford it if they wanted to. There is far too much terrain to cover. Take note. I work for a private company, we do 14,000 calls a year in a city of 110,000 roughly. We also serve over 90% of the county we operate in, not to mention some thousands of miles of area in 3 other surrounding counties. We also provide mutual aide for some 6 or 7 additional cities on a regular basis. But we have investors and billing companies and non county acquired funding. If your county is underpopluated, you simply can not afford paid services to the extent of what some people on here are suggesting.

Don't ever say I didn't try to help.....

You're rendering first aid. No protocol or medical control is required to render first aid.

Thanks for the link. That thing is awesome! I'm looking forward to trying it out. My only concern with my service pushing no-lift is that crews will get spoiled such that they lose any conditioning they had when they have to make some bad akward lifts. We don't have a culture of fitness in EMS and the more widespread these assistive devices come the less likely I see a cultural shift being. So will we cut down on minor workplace injury claims at the cost of increasing the severity of the injury when it does happen? I'm not saying I'm resistant to power cots, tracked stair chairs and the like; I'm strongly in favour of it. I think it just reinforces the need for EMS to push a culture of health. So add that to the list of crap we need to fix in this industry.

My old employer refused to let us even have a treadmill or stationary bike at the station. He said he didn't want people getting hurt. Seriously? Getting hurt? Like standing on the side of the highway in the middle of a snow storm isn't dangerous. They also refused to pay for a corporate gym membership. But then they would complain about people being over weight and out of shape. This all coming from a boss and supervisor whom were the fattest in the company. Personally, I enjoy exercising and feel everyone should do some sort of exercise. It is rewarding and actually makes you feel better, mentally and physically. You do not need to go to a gym, or have a trainer to get into shape. It is very simple. Eating healthier, walking up stairs instead of elevators or escaladors. Taking walks outside with friends or co-workers. Start jogging a little, do sit-ups and push ups... simple people! You can do most of this during commercials of your tv shows you watch for 5hrs at night. edit: only the first paragraph was in response to you Phil, the rest was me rambling.

You still don't give any consideration for the girl he sexually battered and what additional troubles he added to her life. Taking advantage of a troubled youth is probably one of the lowest actions someone could do. I am very surprised he made the FD unless he has some help from a relative within the FD. If his co-workers knew of his problems with drugs, they should also be disciplined since there is that "protect and serve" thing with the FD and that shouldn't mean just protecting their own.

yeah but you kicked ass after hells bells plan I would add, if air not available apply diesel liberally.

Here's a great idea - don't ask on here, pick up the phone, call your state ems office, ask for the legal dept and find out what the state allows, then ensure that flies with the dept you are with. But as others have said, FR are on their way out quickly, most places I know will only hire them as drivers as they can't legally work the back here. Though that is just this area. But if you are serious about this as your profession, get your paramedic.

Or a paramedic

These systems usually have more than one first responder on scene. Math = 2 ECAs + 1 driver= the best full crew they can provide. This posting is nothing more than the product of someone who has nothing better to do with their time than dig up crap to make fun of with out fully understanding the entire basis behind it.

Um NO! I dont get this at all... Volunteer = fail WHY? We are all trained and state certified, paid or not A driver, not two medical professionals = fail I didnt see where it said just one and one? Maybe they need the driver to get 2 in the back 2 members and a driver = fail WHY? Whats so bad about that the last two are not even worth asking about. It is such a shame that this website HATES volunteers so much! We are all part of the same community yet volunteers and firemedics are looked down on like dog crap under a "professional's" boot. Im going to shut up now before I start ranting.....

In 2008 I became certified as a 40-hour first responder at the age of 15. The local health services agency provided the training as a summer boredom buster. Since then I've assisted several indivduals who were experiencing medical emergencies ranging from fainting to a scalp laceration. But here's the catch: our state does not recognize first responders. No protocol for FRs exists within the state. It wasn't until several months ago that I realized this. I've mentioned it to the local EMS and even to the hospital, but they don't seem to see it as a real issue. I'm familiar with FR protocol from other states, but I have no clue as to what I can and can't do in my state. I don't know what I can and can't carry in my jump kit (which was given to me by the instructors for scoring 100% on the final exam). When it was given to me it had activated charcoal and glucose. I know some states allow their FRs to use those two items, but I'm not sure if I can. But the whole point of my post here is to ask some of the experienced EMS people about what types of issues might arise from this issue, and any possible solutions. Thanks